An estimated 4.69 million South Africans are infected with Type 1 human immunodeficiency virus (HIV). HIV infection in incurable and, if untreated, is ultimately fatal in approximately 95% of infected individuals. L frutescens is thought to be among the most efficacious plants used in southern African traditional medicine. The plant has been used in indigenous settings to treat serious microbial infections, especially HIV infection, as well as cancer and inflammatory conditions. Beneficial effects have also been observed in wasting conditions and stress-related disorders. It is possible that L frutescens may have useful effects in HIV infected adults. Early HIV infection has been associated with a significant reduction in quality of life in multiracial South Africans measured by the Medical Outcomes Study HIV Health Survey (MOS-HIV) instrument.23 The observed anti-inflammatory properties of L. frutescens may favourably influence cytokine networks with beneficial effects on quality of life, viral replication and immune functioning. It is essential to document that this widely used phytotherapy can be used safely in HIV-infected adults, and to attempt to demonstrate potentially beneficial affects. Recent data has demonstrated that there are significant in vitro interactions between Sutherlandia and antiretrovirals commonly used to treat HIV infection. We propose a 4- year randomized placebo controlled trial of Lesssertia frutescens in order to determine this plant species' safety and effects on quality of life and markers of HIV disease progression. Specific Aim 1: To determine the safety of Lessertia frutescens used by HIV-1 infected adults. Specific Aim 2: To determine the effect of Lessertia frutescens on quality of life in HIV-infected adults measured by the Medical Outcomes Study HIV Health Survey (MOS-HIV). Specific Aim 3: To assess the influence of Lessertia frutescens on CD4 T-lymphocyte count in HIVinfected adults. Specific Aim 4: To evaluate the impact of Lessertia frutescens on HIV viral load in HIV-infected adults.